Provider Demographics
NPI:1083444624
Name:MELISSA HEINEMANN, PSYD, PLLC
Entity type:Organization
Organization Name:MELISSA HEINEMANN, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINEMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-975-5483
Mailing Address - Street 1:7808 SYCAMORE DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4249
Mailing Address - Country:US
Mailing Address - Phone:708-975-5483
Mailing Address - Fax:
Practice Address - Street 1:7808 SYCAMORE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4249
Practice Address - Country:US
Practice Address - Phone:708-729-5816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health